CORD PROLAPSE Flashcards
What is the definition of a Cord Prolapse?
An obstetric emergency, whereby the umbilical cord slips in front of the fetuses presenting part after membranes have ruptured (RCOG, 2014)
What is the incidence rate of Cord Prolapse?
0.1-0.6& but 1% in a Breech presentation.
What antenatal risk factors are there?
Breech Presentation
Polyhydramnios
Multiparity
Low-birth weight
What intrapartum risk factors are there?
Delivery of second twin
What supporting evidence is there regarding multiparity and a Cord Prolapse?
Dilbaz (2006), found that 49 - 64% in 80 cases were multiparous women.
What are some warning signs that a Cord Prolapse may occur?
Umbilical cord protruding via vulva
During an EPV
FHR is abnormal
First steps taken when a Cord Prolapse occurs?
Call for help (SOAPS)
Call an ambulance if in a comm setting
Who are SOAPS?
Senior midwife Obstetrician Anaesthetist Paeds/Neonatologist Scribe
What is the need for SOAPS?
Senior midwife and Obstetrician for expertise
Anaesthetist for further assistance for a c/s
Paeds/Neonatologist for attendance of birth
Scribe to ensure timely detail in documentation
Second step taken when a Cord Prolapse occurs?
Relieve pressure on cord via knee-chest position or Exaggerated Sims position.
If in a community setting, bladder filling could be used.
What is the knee-chest position?
Mother placed onto all fours -> knees brought up to the chest
What is the Exaggerated Sims position?
Mother placed onto left lateral -> right knee bent upwards with a pillow or two wedged between the legs.
What is bladder filling?
500mls of saline through a catheter to inflate the bladder and dry pad placed inside the vagina.
Third stage taken when a Cord Prolapse occurs?
Tocolysis - Terbutaline 0.25mg subcutaneously
Fourth stage taken when a Cord Prolapse occurs?
Plan and evaluate for immediate birth?
